exposing the dark side of adoption
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To Make A Child Visible


by Robin Munro, Senior Writer

Over the past three years, Holt’s work in Guatemala has focused on moving children out of institutions and into stable, loving families. The project, funded by a grant from the GHR Foundation, has shown remarkable success. No longer invisible to the court system, over 1,000 children have reunited with family members, with many more prevented from entering institutions. Next, Holt aims to take the project to scale, making invisible children visible throughout the country.

Atilio* didn’t know what to do. He earned very little money, and couldn’t afford to give his young daughter everything she needs. He could give her plenty of love, but never enough to eat. He could keep her warm in his arms, but couldn’t provide oil to heat their home. Her mother was often absent, and neglectful of their daughter.

Seeing no alternative, he brought his little girl to a childcare center in Quetzaltenango, near where they lived in Guatemala. He thought at least here, she would always have enough to eat. Here, she would always be taken care of. Here, he thought, she would have all the things he could not give her.

Then he visited her. She immediately ran up to him and threw her arms around his legs. After a moment, he looked around and realized, ‘my daughter does not belong here.’

In Guatemala, over half the population lives in poverty. Like Atilio and his daughter, sixteen percent live in extreme poverty. They live in homes made of tin scraps, have no clean drinking water and, on income of less than $1 per day, have very little to eat. As a result, Guatemala has the highest percentage of malnourished children in Latin America – and the fourth highest in the world.

Often, impoverished families like Atilio’s will make the very difficult decision to relinquish their children into care. Or the court system, deeming their parents unfit, will remove vulnerable children from their families and place them in orphanages.

This may be the worst fate possible. For many, once they enter, they never leave.

“Poor families often think living in an orphanage is better than living in extreme poverty,” explains Philip Goldman, president of child welfare consultancy Maestral International. “Often, that’s not the case.”

Founded as an outgrowth of the Children in Families Initiative of the philanthropic GHR Foundation, Maestral International works to strengthen protection systems for vulnerable children and families throughout the world. In the end of 2008, the Foundation solicited proposals from organizations working to prevent children from entering institutions and move those already in orphanages to safer environments. Holt proposed a project in Guatemala, where Holt program staff had recently completed the first comprehensive survey of institutionalized children ever conducted in the country. Funded by USAID, this survey documented the backgrounds and living conditions of over 7,000 children in orphanage care. With support from the GHR Foundation, Holt hoped to use this survey as a starting point to remodel Guatemala’s overall system of child welfare.

The main objectives were four: “To reduce the inflow of children into institutions, to reduce the time they had to stay there, to successfully reunite them with their families, and to then monitor their wellbeing,” explains Sarah Halfman, Holt’s director of programs in Latin America, Haiti and Romania.

Of 179 applicants, Holt was one of five organizations selected to receive support.

Holt is now in the third and final year of the grant. As the technical advisor on the project, Goldman recently traveled to Guatemala to observe Holt’s progress.

“In 2 years, they have placed over 1,000 children with domestic families,” says Goldman. “To me, that is a remarkable result.” In partnership with local organizations, Holt has successfully placed children with parents, grandparents, aunts, uncles – any relative who could provide a safe home environment and more nurturing care than the child would receive in an orphanage. (As Guatemala suspended international adoption in 2008, joining families overseas is not currently an option for these children. Even so, Holt’s first priority is always to keep a child within his or her birth family, whenever possible.)

Overcrowded and understaffed, orphanages in Guatemala are often dangerous, volatile places. But even if a child escapes physical harm, the psychological harm can be even more devastating.

In one ongoing study conducted in Bucharest, researchers found that children living in orphanages had very little brain activity. They smiled less, laughed less, had lower IQs and more mental illness. Starved of the nurturing, individual attention they needed to develop at a normal, healthy rate, their language and social skills became severely stunted. But once placed in foster care, they made dramatic strides.

Since the mid-1960s, Holt has worked around the world to move children out of institutions and into foster care or other family-like environments. One of Holt’s greatest successes occurred in Romania after the fall of the Ceausescu regime in 1989. Amid an international outcry over the warehousing of children in squalid institutions, Holt, in 1993, was able to introduce foster care on a series of USAID grants – leading to significant deinstitutionalization of children in Romania over the next 12 years.

What Holt helped achieve in Romania, they are now striving to do in Guatemala.

After years of working in the field –including 13 as a member of the World Bank’s human development team – Goldman knows it’s a daunting task. “When I was working in the former Soviet Union, we were extremely pleased when programs were able to deinstitutionalize tens of children in a year,” he says. “I have a good appreciation for how challenging it is.”

In Guatemala, Holt took a unique approach. They made the children unable to ignore.

“What Holt has done remarkably well – and different from in other countries – is to find a way to make these children visible,” says Goldman. After identifying the names and ages of the children in Guatemala’s orphanages, and noting how long they’d been in care, Holt brought their cases back to the attention of the regional courts – then floundering under a massive backlog of child welfare cases. “It’s not that no one was trying,” Halfman says of efforts to resolve cases. “The system was just so overwhelmed.” After a pilot test, Holt created a new system for mediating child welfare cases.

“[Holt is] thinking systemically, not just in one dimension,” says Goldman.

In Quetzaltenango – where Atilio and his daughter live – Holt implemented a “One Stop Shop” (OSS) intervention model. Where before, families had to bounce around from one place to another to receive all the legal and support services they needed, “the OSS brings everything together for children in one spot,” says Halfman. Lawyers, social workers and psychologists now mediate the cases in one, centralized location.

The result: backlog, unclogged.

The time it takes to determine a child’s fate has fallen from over a year, in some cases, to a matter of days. On a recent evaluation of the project, a delegate from the local court in Quetzaltenango told the reviewer, “Because of the OSS, we are able to provide children with complete and timely justice.”

On his recent trip to Guatemala, this outcome became very real for Goldman. In Quetzaltenango, he had the chance to observe a family mediation at the OSS. The mediation was for Atilio, his daughter – Celia* – and her mother.

Afterward, they went to the neighboring courthouse for their hearing. Celia sat in a playroom with the court psychologist. In a different room, her parents and the judge could see Celia and hear her responses to the psychologist’s questions via Halo camera. Holt implemented this feature after discovering that within the existing system, children were often forced to endure court hearings in the same room as their aggressors.

After the psychologist questioned Celia, it became clear it was in Celia’s best interest to stay with her father. The judge granted full custody to Atilio.

“This was a very moving experience,” says Goldman. “I saw both the professionalism and seriousness of the process… and then I got to see the faces of the father and daughter when they were reunited.”

Goldman believes Atilio was always acting out of love. His decision to place Celia in an orphanage was an act of love. And later, when he decided to gain custody, he acted on love. He came to see that where she belonged was with him – a person who would always love her and take care of her as best he could.

Through the OSS, Holt would not only help Atilio reunite with Celia, but also help him give her the best care possible. “[The OSS staff] spent a lot of time talking with the father about the child’s needs,” says Goldman. Atilio’s economic situation had not improved, and he still had to consider how he would provide for his daughter. Holt cannot afford to support every family reunited through the OSS. But by partnering with local organizations in the community, Holt can link families to the resources they need. “Parents can go to the OSS for education, assistance with healthcare,” says Halfman. “Any service they need, OSS directs them where they need to go.” As in other countries where Holt has developed “family preservation” programs, Holt is working in Guatemala to strengthen and stabilize families like Atilio’s – ensuring children may grow and thrive in the loving care of their own parents.

With over 1,000 children moved from institutions into family settings, and many more prevented from entering orphanages in the first place, Goldman believes Holt’s work in Guatemala may have a much bigger impact than originally anticipated. “Globally, there can clearly be lessons learned about making invisible children visible and then helping them once they’re out,” he says.

The project will continue to face more challenges in the future. Greater engagement with the Guatemalan government will help ensure sustainability in the three communities where Holt has established programs. Looking forward, Holt also hopes to deepen and strengthen current services, as well as bring them to scale throughout the country.

But the future looks bright.

“We’ve shown it does work. It does reduce the trauma to the child. It does reduce the time a child has to stay in an institution,” says Halfman of the new child welfare model. “It’s unprecedented what we’re doing.”

* name changed

2011 Apr 1